sputum cultures

[3timesthefun]

One of my children was recently hospitalized and had a positive pseudomonas culture for the first time. The clinic had us bring the other two in to be cultured. My daughter's came back negative. But my other son grew a gram negative bacillus. The doctors were stumped and didn't know what to think. The are going to retest him next week. Anyone have any similar results? I find it hard to believe that they didn't know what it meant.

 

[Diana]

From what I know gram negative bacillus is the term to cover a large range of clinical bacteria (not to sound scary). He might have a bug to be treated and they should have been able to identify it through the sputum culture. I am confused too - if they could identify it was gram negative bacillus then shouldn't they have been able to see which one it was? I hope you get some good results from the new test.

 

[Seana30]

Courtney's culture showed positive for gram negative bacilli, but we were told that it is a "normal" bug, that it is nothing to worry about.

Please keep us informed of the results.

Seana

mom to

Lauren-15, no CF
Courtney-13, with CF
Cameron-10, no CF

 

[anonymous]

Two bacterias that my daughter often cultures are Haemophilus Influenza (H. Flu) and Stenotrophomonas Maltophilia. Both are gram negative bacilli. I'm sure there are more.

H. Flu is often considered a "normal bug" because it is often seen in cultures, even when someone is not sick (even in people who do not have CF). However, I have noticed that when my daughter does culture H. Flu she is usually having respiratory symptoms. So it can contribute to a flare-up.

Usually a lab will be able to identify the bacteria as a gram negative bacilli within a day, but it takes a couple of days for it to grow out in order to identify what specific bacteria it actually is.

Maria (mom to Sami, almost 3 yrs. old, w/cf)

 

[anonymous]

Pseudomonas aeruginosa is a gram-negative bacteria.

 

[anonymous]

But I think Pseudomonas is a gram negative "rod" not a gram negative bacilli.

Actually - I just learned that today because Sami is culturing a gram negative bacilli, presumably Stenotrophomonas. Our nurse practitioner said that is probably wasn't pseudomonas because pseudomonas is labeled as a gram negative rod.

Learn something new everyday!!!!

Maria (Sami's mom)

 

[LisaV]

From( <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Gram-negative">http://en.wikipedia.org/wiki/Gram-negative</a> )


"Gram-negative bacteria are those that do not retain crystal violet dye in the Gram staining protocol. Gram positive bacteria will retain the dark blue dye after an alcohol wash, but Gram negative do not. In testing for a gram stain, a counterstain is added after the crystal violet, which colors all gram-negative bacteria a red or pink color. The test itself is useful in classifying two distinctly different types of bacteria based on structural differences."

CFers are often colonized by gram-negative bacteria.
Pseudomonas aeruginosa, Burkholderia cepacia, and Serratia marcescens are all gram-negative bacteria.

 

[LisaV]

Hmmm...

This says that "The term bacilli (singular bacillus) is used to refer to any rod-shaped bacteria" ( <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Bacilli">http://en.wikipedia.org/wiki/Bacilli</a> ). That's bacilli and bacillus with a small "b". And this one ( <a target=_blank class=ftalternatingbarlinklarge href="http://gsbs.utmb.edu/microbook/ch027.htm">http://gsbs.utmb.edu/microbook/ch027.htm</a> ) says that "Pseudomonas aeruginosa is a Gram-negative rod measuring 0.5 to 0.8 µm by 1.5 to 3.0 µm. "
Stentrophomonas maltophilia is also a gram-negative bacteria - also a rod, if I read this one correctly (see <a target=_blank class=ftalternatingbarlinklarge href="http://www.cdc.gov/ncidod/eid/vol7no1/valdezate.htm">http://www.cdc.gov/ncidod/eid/vol7no1/valdezate.htm</a> ).

While Bacillus with a large "B" is one genus of rod-shaped bacteria (see <a target=_blank class=ftalternatingbarlinklarge href="http://en.wikipedia.org/wiki/Bacillus">http://en.wikipedia.org/wiki/Bacillus</a> ). Here's information on the genus Bacillus <a target=_blank class=ftalternatingbarlinklarge href="http://medic.med.uth.tmc.edu/path/00001437.htm">http://medic.med.uth.tmc.edu/path/00001437.htm</a> .

Amazing what infectious disease specialist we all become.
I sometimes thought that having a first husband who was a medical microbiologist had ended up being a virtue (didn't think that when I divorced him, obviously).

 

[Seana30]

I AM SO CONFUSED!!!!!!

If gram negative is a bad thing for CFers to have why was I told not to worry about what Courtney cultured?

Should I be worried? Should I go talk to the doc??

Seana

 

[thelizardqueen]

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Seana30</b></i>

I AM SO CONFUSED!!!!!!



If gram negative is a bad thing for CFers to have why was I told not to worry about what Courtney cultured?



Should I be worried? Should I go talk to the doc??



Seana</end quote></div>


Don't you just love doctors? - I was told that Aspergillus is a normal bacteria, and that I should not ever worry that I am culturing it, and seem to have problems with my lungs. I found out later on, that Aspergillus isn't a good thing to have, and that you can get a reaction from it. As anyone else experienced this? - docs telling them not to worry about something and that everything is fine and normal, but then find out later that your doctor told you a white lie? I don't always trust docs because of this. Better to do my own research, then to sit back and listen to what my docs say as truth.

 

[skh]

My problem with our local cf doc is that the clinic does not automatically send us the results of my daughters sputum cultures or anything else. Once we leave the clinic it's like "out of sight out of mind" and they don't give another thought to my daughter until the next visit. Is this normal procedure? I would like the results no matter what they are. I know when she has her yearly visit to the University of MN they send us a report stating what tests were done and the results of those tests.

Sue

 

[thelizardqueen]

I think that's standard with every clinic - unless you are growing something very funky. I've decided to take it upon my self to get copies of all my sputum cultures mailed out to me. Ever since my Aspergillus episode, I want to do my own research on what I'm growing, and not wait for a doc to tell me whether its a "normal" bug or not.

 

[anonymous]

Our local CF clinic sends a report after each clinic. Always the same -- DS is a happy active child who was diagnosed at birth. It's pretty much a narrative of each doctor & CF team members view on "how we as parents are handling ds's CF. The nurse used to call and say, DS cultured pseudo, but don't worry 'cuz it's rare. So I've started requesting reports from the main clinic pertaining to that date -- culture results, labs, xrays... I was once told that Xrays showed infiltration by the pulmonolosist. Got the radiology report -- that pretty much said the xrays weren't any good because DS was squirming and screaming at the time.

When DS was first diagnosed, the hospital had a book they kept at DS's bedside that had lab results, nurses and doctors notes and we were encouraged to look at it. Was wonderful 'cuz we felt we knew what was going on. Not the case when DS had to go to the local hospital because of an infection. A med student was sent in to tell us that DS's white count was really high, but not to worry about it. Worry more if it's really low. I soooo wanted to storm the nurses station and grab ds's chart. Liza

 

[LisaV]

Well....there's a difference between being colonized by a bacteria and infected by a bacteria. If you are colonized then when they take a culture stuff will grow out, but they'll only say you're infected by that thing if your symptoms have changed (green mucus, bad pfts, etc). Sooner or later almost anyone with bronchiectasis ends up being colonized by pseudomonas, but if they "do the right things" (even to taking TOBI every other month or something) it won't change their symptoms.

I always wondered what the docs meant when they said "oh, it's a 'normal' bug". Normal for me with my healthy lungs, or normal for him with juicy lungs from bronchiectasis and a lousy immune system from a lifetime of being on/off steriods. Or maybe normal because someone his age with bronchiectasis was almost bound to have the bug by them and there weren't very many and his other numbers were good (that is, normal in the sense of not something we think we should treat).

So we'd just ask for the actual numbers, get the actual lab report.

 

[anonymous]

Seana-

I'm guessing the gram negative your daughter grew was H. Flu. Sometimes when Sami grows this, they don't even mention it because it is considered such a "normal" bug. But as I said before, it can flare-up and cause problems.

Maybe you can call your doc and ask specifically what grew out. I keep a folder for Samantha's CF info. One sheet is just for culture results. I made a table with these headings: date/ symptoms/ type of culture (throat, sputum, bronch) / results. This way I can easily see everything that she has ever cultured and when she cultured it.

Maria (Sami's mom)

Lisa - thanks for all the great additional info!

 

[Diana]

Seana don't be alarmed by all this info just yet. When I checked out a list of gram neg bac, it did include those nasty ones that cfers want to avoid but there were a lot of other bacteria to consider also....and I mean "A LOT". So I am guessing your docs said not to worry just yet becasue they would need to identify the bug first. I was confused (as previously stated) because I would have thought that if they knew it was gram neg bac then they could have used their automated systems to figure it out in like an hour. BUT maybe there wasn't enough or it was a rare bug so they couldn't identify it straight away....to me that could be a good indication becaue they would be fairly use to seeing pseudomonas and cepacia so hopefully those can be cancelled out of the equation.

I could of course be completely wrong but those are my thoughts on the topic for now. Sit tight until they do know what they are dealing with and hopefully it won't cause any problems.

Don't you think that on top of all the health issues we have to deal with, the headache of just not knowing what is going on can be just as bad? Hang in there and hopefully you will find out soon.

 

[Seana30]

Thanks for all the info everyone.

Courtney has never had lungs issues up till now so all this new info is quite confusing!

Thanks again to everyone.

Seana

 

[3timesthefun]

Thanks for all the info.

I got the final report print out it stated Many Bacillus species. Our doctor still says she is not sure if it means anything, unable to identify which species. We are going back next week to reculture.